“You can’t go wrong with getting strong”
This is a popular phrase in the rehab and fitness spaces and it rings true in regards to health and wellness. Strength is one of the most important markers of health.
Research suggests quad strength and grip strength are primary predictors of mortality. Another study showed hip flexor strength was the primary determinant in the progression of functional capacity decline. Furthermore, low muscle strength and power, but not low muscle mass, are more strongly associated with falls, fractures, and mortality.
This doesn’t mean muscle mass isn’t important — it raises the floor and ceiling of strength development and is directly responsible for glucose control and our metabolism — but it does point to the need to often focus specifically on strength and power development when exercising.
Here’s the big problem: very few people are getting strong.
The current World Health Organization (WHO) physical activity guidelines recommend adults (aged≥18 years) perform muscle-strengthening activities at least twice per week. If you had to guess, what percent of people do you think meet those guidelines?
According to a 2020 study in Sports Medicine — Open which included over 1.6 million participants, only 10–30% of adults report meeting current muscle-strengthening activity guidelines, while 50% met the aerobic activity guidelines (≥ 150 min/week). When moving the assessment to adults over the age of 50, then strength training guidelines are met in a mere 6% of the population.
Why are the numbers so low?
First, I would argue the primary reason is barriers to entry. No equipment is required to aerobically train; go for a run outside barefoot. That doesn’t mean no barriers exist (safe area to run, child support if a single parent, time, etc.) but finding and paying for access to heavyweights and machines takes more time, money, and effort. Running is also something we have done since childhood — resistance training near max effort is not.
With all of that said, strength training can be done without needing a squat rack and barbells. Calisthenics (bodyweight exercises) can be manipulated to be extraordinarily challenging (e.g., planche pushups — basically pushups with both feet in the air).
Strength is built by training at our near maximum loads (e.g.≥85% one-repetition maximum). Traditionally, strength training requires rest breaks of at least 2 minutes — often 5 to 7 — to allow for adequate recovery for repeated high-effort lifts. Training volume is often up to 15 sets per muscle group per week, leading to 3 to 5 sessions lasting 45 to 75 minutes each.
Time is now a major barrier. It doesn’t have to be, however.
Volume is king for hypertrophy but high resistance is king for strength
What are minimal dose approaches?
A prime example of a minimal dose workout is a Pinterest workout. You find a graphic that outlines a four-minute workout involving 4–5 movements you repeat. For example, in four minutes, do as many rounds as you can of 10 pushups, 15 sit-ups, and 20 air squats.
These types of routines largely target your cardiovascular system and are deemed aerobic exercises, as they are low intensity regarding the percent of your one-repetition maximum. That doesn’t mean they are easy, it just means you won’t build much strength or power.
This recent study outlines how minimal dose approaches can be successful in building strength and power when designed appropriately.
This is great news.
It gets even better when we realize strength can be built around many of the barriers to exercise that exist today. Two of the biggest barriers — time and equipment — can both be navigated with a minimal dose approach.
You have two options: brief, vigorous exercise and exercise snacking.
The American College of Sports Medicine defines brief, vigorous exercise as ≤ 5 minutes exercise, whether it be continuous or a cumulative total throughout interval training (e.g. 5 x 1-minute intervals). Conversely, ‘exercise snacks’ are multiple shorter bouts of vigorous exercise — less than 20 seconds — which are performed throughout the day, leading to multiple hours of rest between bouts.
When looking at the strength training research, brief, vigorous exercise is translated to low volume training. For building strength, the volume needs to be slightly higher than for aerobic training. A Tabata routine (20 seconds on, 10 seconds off, high effort cycling for 4 minutes) works for building aerobic and anaerobic capacity, but strength training requires more time for recovery.
Many of the routines will be as low as 20 minutes though. Get under the barbell, knock out a couple of high-effort squat sets, and your strength improves. You won’t build muscle, but you will build strength with a small-time commitment.
Now think about how these strategies can be incorporated into your daily routines.
First, what exercises are realistic for you? If you have access to a gym, perhaps you can go the brief, vigorous route and spend less time in the gym, focusing on strength and leaving. If you want to build muscle, you will need to take a different approach.
If you don’t have access to a gym — either commercial or home gym or equipment — then calisthenics is your friend. Here are some progressions you can use to increase the intensity and build strength:
- wall push-ups
- knee push-ups
- standard pushups
- wide and narrow grip pushups
- diamond pushups
- Triceps press
- Pike press
- One-arm push-up
- Planche holds
- Planche push-up
- Sit to stand with varying seat heights
- Air squat
- Singe Lunge
- Split Squat
- Rear-foot elevated split squat
- Shrimp Squat
- Pistol Squat
You can also add pulling exercises (pull-ups) with a bar. There are inexpensive options that fit in a doorway. Calisthenics can either be performed as a brief, vigorous routine or a snacking routine.
Set an alarm on your phone and every 2 hours complete one max set of a single pushup or squat routine. Pick one that will cause you to fail by 20 seconds.
Again, these routines won’t build muscle or improve your cardiovascular health, but they will build strength. That doesn’t mean low volume won’t have some effect on muscle size.
Little time and effort are needed to maintain muscle
Exercise is cyclical. Our training evolves throughout our lives for two primary reasons:
- We adapt through training, requiring more intensity, and potentially volume, to continue progressing in strength, power, hypertrophy, and aerobic capacity.
- Life events —having a child, grad school, a new career — force us to prioritize and organize our time.
When I had each of my two children, my sleep suffered dramatically. It is hard to build muscle when you are sleep-deprived; it’s hard to find the motivation to exercise regularly, even. In some cases, your goal may simply be to sustain muscle mass.
The good news is this is much easier than building muscle.
If you stop training altogether, you will maintain muscle for roughly three weeks, but atrophy and strength loss will hit hard after that. It doesn't take much to stop that loss of muscle and strength.
Studies have shown a single training session a week can maintain muscle mass. Furthermore, a single set of exercise for a muscle group may retain muscle mass, provided it is a challenging set. This effect has been repeated in young populations, but in elderly (60+ years old) individuals it’s unclear.
Studies have shown elderly and very elderly (75+) can build muscle and strength with 1–2 sessions per week. This study, however, showed elderly did not maintain the muscle gained after a recent 16-week program, returning to baseline by the end of a 32-week maintenance program.
Of note, the maintenance programs only lasted up to 32 weeks in all of the studies mentioned. It is not known if maintenance strategies will last long-term. But it is comforting knowing that you can take a 7–8 month break from rigorous training and maintain your muscle mass and strength.
Strategies to improve exercise efficiency
A recent research review in Sports Medicine takes a look at the current state of exercise research to help us understand how to be more efficient with exercise. This review looked specifically at building muscle and strength but some of the strategies still apply to aerobic training.
Keep in mind, these strategies are for improving your overall health and specific health markers (e.g., strength, power, muscle development, aerobic capacity) and not for achieving task-specific goals (e.g., running a marathon or setting a squat personal record). If you want to push the body to its fullest potential then high volume (and potential long duration) training is necessary. As you will see, you don’t need substantial time to become fit and healthy.
1. Optimize your training frequency
The review in Sports Medicine covers exercise frequency and it supports the same ‘brief, vigorous’ and exercise snack approaches mentioned earlier. They use the term ‘micro dosing’ when referring to workouts less than 15 minutes. The common theme is the total volume of exercise needs to match that of traditional training to achieve equivalent improvements in hypertrophy (e.g., four 15-minute micro workouts instead of one 60-minute traditional workout).
Remember, volume is king for hypertrophy — and building tolerance for long-duration aerobic events — but not for strength and power.
2. Prioritize multi-joint exercises
Multi-joint exercises should be prioritized as they induce a greater metabolic stimulus in a shorter amount of time than single-joint exercises. If you have the time to do a 90–120 minute workout, throw in the bicep curls. If you are trying to be time-efficient, hit biceps with your back during rows or pull-ups.
How about machines vs. free-weight? This one is tricky. Machines, like single-joint exercises, are easier to perform, making them a favorite of novice lifters. It is easier to add load and train at a high intensity without worry about form. Machines, however, require time and space, limiting the option for at-home workouts.
For home workouts, free weights, resistance bands, and body-weight exercises are the most common options. Resistance bands are the inferior option, but they can still lead to positive results. As your training improves, you have to be more creative with body-weight exercise programming. Some calisthenics workouts can among the most challenging workouts available, however. Free weights give you more options, particularly for high loads, potentially making the workouts more time-efficient.
3. Change the structure of your exercise sets
Other time-saving techniques include supersets, drop sets, and rest-pause. These methods can cut training time in half while maintaining training volume. Here is a brief description of each:
- Supersets: performing two or more exercises in succession with limited or no rest between them (see below).
- Drop sets: perform a traditional set, reduce the load (often 20–25%), then immediately perform another 1–3 sets. Each drop set is performed to failure.
- Rest-pause method: Building mini-rest periods within a set. Here is an example from one study showing greater hypertrophy for the rest-pause group. The traditional group performed 3 sets of 6 repetitions with 80% of 1 rep max with 2–3 minutes of rest between sets. The rest-pause group performed one set to failure (also 80% of 1 rep max load) with a 20 s interset rest interval until a total of 18 repetitions was performed. The traditional group took 57 minutes to complete the session while the rest-pause group took only 35 minutes.
4. Minimize the warm-up
The goal of a warm-up is to increase metabolic activity to prepare for exercise. The warm-up should be specific to the intended training. If you are going to squat heavy, start with a set of air squats followed by sets under the bar with gradually increasing the weight. Keep the reps low to minimize fatigue.
If you are training at light loads — such as a bodyweight workout — you can jump right in.
As you can see with the various studies and approaches to exercise in this article, we can achieve many health benefits with low-volume training. Something is better than nothing.
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